Individual provider Active NPI

Roy E Smith, MD

  • Addiction Medicine (Family Medicine) Physician
  • Yreka, CA
National Provider Identifier
1245287291
Registry record updated Nov 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X
License
191926 Issued in CA
Practice address
475 Bruce St
Yreka, CA 96097-3474
Phone
(530) 842-3507
NPI assigned
May 27, 2006
Last updated
Nov 15, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 191926 CA
Addiction Medicine (Family Medicine) Physician 207QA0401X 191926 CA Primary

Addresses

Primary practice location

475 Bruce St
Yreka, CA 96097-3474

Mailing address

475 Bruce St
Yreka, CA 96097-3474
Phone (530) 842-3507

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240109004078 CA Practitioner - Family Practice 7416928270 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Addiction Medicine
Education
Medical University of South Carolina College of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Siskiyou Hospital IncGroup PAC ID 1254223134, 96 clinicians

Practice addresses (Care Compare)

444 Bruce St
Yreka, CA 96097-3450
Phone (530) 842-4121

475 Bruce St
Yreka, CA 96097-3474
Phone (530) 842-4121

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
191926CAMDAddiction Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Siskiyou Hospital, Inc. CurrentSince Nov 13, 2023 Accepting new patients
Alice J. Brooks, MD, PA Past Accepting new patients
Siskiyou Hospital Inc PastSince Dec 29, 2019 Accepting new patients
F N McCorkle Jr., MD PA Past Accepting new patients
Mill Street Medical Associates, LLP Family Medicine Past Accepting new patients
Roy E. Smith, M.D. Family Medicine PastSince Oct 1, 2008 Accepting new patients

Locations

444 Bruce St
Yreka, CA 96097
Phone (530) 841-6256

475 Bruce St
Yreka, CA 96097
Phone (530) 842-3507

475 Bruce St
Ste 900
Yreka, CA 96097

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700006400000",
    "number": "1245287291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 BRUCE ST",
            "city": "YREKA",
            "state": "CA",
            "postal_code": "960973474",
            "telephone_number": "530-842-3507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 BRUCE ST",
            "city": "YREKA",
            "state": "CA",
            "postal_code": "960973474",
            "telephone_number": "530-842-3507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "ROY",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-27",
        "last_updated": "2023-11-15",
        "certification_date": "2023-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "191926",
            "primary": false
        },
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "CA",
            "license": "191926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yreka, CA

Sources for this page

Verify at the official NPI Registry.